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1.
Aging Clin Exp Res ; 36(1): 89, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38598143

RESUMO

BACKGROUND: Whether, and to what extent, frailty and other geriatric domains are linked to health status in patients with transthyretin cardiac amyloidosis (ATTR-CA) is unknown. AIMS: To determine the association of frailty with health status [defined by the Kansas City Cardiomyopathy Questionnaire (KCCQ)] in patients with ATTR-CA. METHODS: Consecutive ATTR-CA patients undergoing cardiovascular assessment at a tertiary care clinic from September 2021 to September 2023 were invited to participate. KCCQ, frailty and social environment were recorded. Frailty was assessed using the modified Frailty Index (mFI), mapping 11 variables from the Canadian Study of Health and Aging (frailty ≥0.36). RESULTS: Of 168 screened ATTR-CA patients, 138 [83% men, median age of 79 (75-84) years] were enrolled in the study. Median KCCQ was 66 (50-75). wtATTR-CA was the most prevalent form (N = 113, 81.9%). The most frequent cardiac variant was Ile68Leu (17/25 individuals with vATTR-CA). Twenty (14.5%) patients were considered frail, and prevalence of overt disability was 6.5%. At multivariable linear regression analysis, factors associated with worsening KCCQ were age at evaluation, the mFI, NYHA Class, and NAC Score. Gender, ATTR-CA type, phenotype, and LVEF were not associated with health status. DISCUSSION: In older patients diagnosed with ATTR-CA, frailty, symptoms, and disease severity were associated with KCCQ. CONCLUSIONS: Functional status is a determinant of quality of life and health status in older individuals with a main diagnosis of ATTR-CA. Future research may provide more in-depth knowledge on the association of frailty in patients with ATTR-CA with respect to quality of life and prognosis.


Assuntos
Amiloidose , Fragilidade , Masculino , Humanos , Idoso , Idoso de 80 Anos ou mais , Feminino , Qualidade de Vida , Pré-Albumina , Estudos Prospectivos , Canadá , Nível de Saúde
2.
Psychol Health Med ; 29(1): 66-78, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38156665

RESUMO

Caregivers' psychological well-being is linked to the quality of care provided for familiar with chronic illness. Despite caregivers of cardiac patients present an impaired psychological well-being, less investigated is the psychological well-being of caregivers of individuals with a rare disease such as the Transthyretin Cardiac Amyloidosis (ATTR-CA). Specifically, given that no study explored the well-being of the caregiver and the caregiver-patient relationship, this study aimed to analyze the prevalence of anxiety and depression in ATTR-CA caregivers and if these disorders were associated with patient's and caregiver's characteristics. Fifty-eight dyad caregiver-ATTR-CA patients completed the Hospital Anxiety and Depression Scale and the Network of Relationships Inventory. Moreover, ATTR-CA patients completed the Kansas City Cardiomyopathy Questionnaire, while caregivers completed the Multidimensional Scale of Social Support. Results showed that anxious caregivers (44%) reported higher conflict with patients. They had ATTR-CA relatives with a worse perception of cardiac symptoms and higher anxiety and depression. Depressed caregivers (39%) reported higher conflict with ATTR-CA relatives and lower perceived social support. Caregiver reported a high prevalence of anxiety and depression associated with worse personal relational well-being and to patient's psycho-physical condition. The care of ATTR-CA patient should consider the caregiver well-being.


Assuntos
Amiloidose , Cuidadores , Humanos , Cuidadores/psicologia , Bem-Estar Psicológico , Ansiedade/epidemiologia , Prevalência
3.
Aging Clin Exp Res ; 35(6): 1363-1367, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37129709

RESUMO

Aim of the study was to explore frailty and quality of the relationship with the caregiver in a cohort of older patients with transthyretin cardiac amyloidosis (ATTR-CA). Sixty-eight consecutive ATTR-CA patients were recruited and assessed for frailty, depressive symptoms, quality of the relationship in terms of social support, or conflict toward caregivers, New York Heart Association Class (NYHA), and National Amyloid Center score (NAC Score) for grading disease severity. Results showed that 10% of patients were frail. Depressive symptoms were present in 46% of patients. Regression analyses showed that both mFI and depression were associated with worse perception of social support, and that mFI and NAC score were associated with higher levels of conflict perceived in the caregivers' relationship. Overall, the mFI score was associated with worse perceived social support and caregiver relationship quality. Tertiary care heart failure clinics should actively support the patient-caregiver relationship to improve quality of life.


Assuntos
Amiloidose , Cardiomiopatias , Fragilidade , Humanos , Idoso , Cuidadores , Pré-Albumina , Qualidade de Vida , Fragilidade/complicações , Amiloidose/complicações , Cardiomiopatias/complicações
4.
Matern Child Health J ; 27(4): 711-718, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36720772

RESUMO

INTRODUCTION: Psychosocial risks increase the levels of not-integrated/ambivalent and restricted/disengaged representations during pregnancy, but no study has specifically analysed the impact of the COVID-19 pandemic on maternal representation styles. OBJECTIVES: (1) to compare maternal representation styles in primiparous women who became pregnant before and during the COVID-19 pandemic and (2) to analyse the content of representation styles during the COVID-19 pandemic. METHODS: A total of 37 Italian pregnant women were recruited from 2019 to 2021. The sample was divided into two groups: the pre-COVID-19 group (22 women, mean age = 33.14 years; SD = 3.78) and the COVID-19 group (15 women, mean age = 35.9 years; SD = 4.6). Interviews on maternal representations during pregnancy were administered and analysed for style and content. RESULTS: Women during the COVID-19 pandemic reported more restricted/disengaged and less integrated/balanced representation styles than women pre-COVID-19. Content analysis showed that the COVID-19 pandemic led women to focus more on concrete aspects of pregnancy in lieu of emotional aspects, thus leading them to develop more restricted/disengaged representation styles. CONCLUSIONS FOR PRACTICE: In future pandemics pregnant women should be supported in focusing their attention to emotions, sensations and fantasies about themselves as mothers and their children.


Assuntos
COVID-19 , Criança , Feminino , Gravidez , Humanos , Adulto , COVID-19/epidemiologia , Pandemias , Mães/psicologia , Gestantes/psicologia , Emoções
5.
BMC Pregnancy Childbirth ; 22(1): 191, 2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35260098

RESUMO

BACKGROUND: The COVID-19 social restrictions have increased the risk for depression compared to the previous period in Italian women with Low-Risk Pregnancy (LRP). lLess is known about the impact of COVID-19 restrictions on High-Risk Pregnancy (HRP). This study aimed: 1) to explore levels of depression in women who become pregnant before and during COVID-19 pandemic, distinguishing between LRP and HRP; 2) to analyze the impact of COVID-19 restrictions on pregnancy experience in LRP and HRP. METHODS: A before-during COVID-19 pandemic cross-sectional study was carried out on 155 pregnant women (Mean age = 34.18), between 23 and 32 weeks of gestation. 77 women were recruited before COVID-19 pandemic (51.9% LRP; 48.1% HRP) and 78 women were recruited during COVID-19 pandemic (51.3% LRP; 48.7% HRP). HRP group was enrolled during hospitalization for high-risk pregnancy. Participants filled out Edinburgh Postnatal Depression Scale. Moreover, only COVID-19 group answered an open-ended question about the impact of restriction on pregnancy experience. RESULTS: HRP women reported higher levels of depressive symptoms than LRP. No difference emerged for COVID (before/during) but an interaction effect between COVID-19 and obstetric condition was found. The qualitative results showed the impact of restrictions on emotions and concerns. CONCLUSION: Respect to the previous period, LRP women during COVID-19 presented an increased risk for depressive symptoms than HRP. The HRP women during COVID-19 seemed to use hospitalization as a resource to find a social support network with other pregnant women and to be reassured on the clinical ongoing of pregnancy.


Assuntos
COVID-19/psicologia , Depressão/psicologia , Gravidez de Alto Risco/psicologia , Gestantes/psicologia , Adulto , Estudos Transversais , Emoções , Feminino , Hospitalização , Humanos , Itália , Pessoa de Meia-Idade , Gravidez/psicologia , Escalas de Graduação Psiquiátrica , Qualidade da Assistência à Saúde , Quarentena/psicologia , SARS-CoV-2
6.
J Reprod Infant Psychol ; 40(6): 577-589, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-34000926

RESUMO

OBJECTIVE: Lombardy was the most affected Italian region by COVID-19. To limit the spread of infection, the government issued a national social lockdown. The obstetrical-gynaecological emergencies and essential services were guaranteed to protect pregnant women's health, and a return to a medicalised childbirth was necessary. This situation could had amplified risk factors on the psychological wellbeing of mothers-to-be. Indeed, the last trimester of pregnancy is a period of increased vulnerability itself. METHOD: For better support women who experience pregnancy during social lockdown, we explored the impact of COVID-19 on psychic wellbeing of two samples of pregnant women (40 living in Lombardy and 35 in Tuscany). RESULTS: T-test and correlations analyses revealed that women living in the Lombardy had a higher perception of the centrality of COVID-19. Further, women that considered the pandemic as a significant event, experienced a higher perinatal depressive symptom. Those symptoms also arose in women who presented a higher number of intrusion and hyperarousal symptoms and a lower ability to plan. CONCLUSION: Pregnant women should be closely monitored and supported, especially those who live in high-risk areas, such as Lombardy Region. The target intervention could be focused on improving resilience to reduce depressive symptomatology.


Assuntos
COVID-19 , Feminino , Gravidez , Humanos , Gestantes/psicologia , Controle de Doenças Transmissíveis , Pandemias , Parto/psicologia
7.
Int J Psychol ; 57(1): 146-152, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34467528

RESUMO

The COVID-19 pandemic and consequent lockdown represent risk factors for the mental health of pregnant women. We explored the impact of COVID-19 restriction policies on psychological health, analysing the predictive role of social support on maternal wellbeing. A total of 212 pregnant women recruited from two public hospitals in Italy were divided into two groups: (a) a pre-COVID-19 group composed of 141 expectant women (mean age = 34.6; SD = 4.3) at their third trimester before the national lockdown period; (b) a COVID-19 group composed of 71 pregnant women (mean age = 33.3; SD = 4.5) at their third trimester during the COVID-19 national lockdown. Participants completed two self-report questionnaires: the Profile of Mood States and the Multidimensional Scale of Perceived Social Support. Moreover, the COVID-19 group was asked to respond to an open question concerning worries about their pregnancies and COVID-19. Results showed that pregnant women during COVID-19 presented higher anxiety, depression and hostility, and lower vigour, than the pre-COVID-19 group. The main concerns were related to the effect of hospital restriction policies on childbirth and fears of contracting COVID-19. Perceived partner social support represented a protective factor only for the pre-COVID-19 women. Limitations, strengths, and theoretical and clinical implications are discussed.


Assuntos
COVID-19 , Gestantes , Adulto , Ansiedade , Controle de Doenças Transmissíveis , Depressão , Feminino , Humanos , Mães , Pandemias , Gravidez , SARS-CoV-2 , Inquéritos e Questionários
8.
J Reprod Infant Psychol ; 39(3): 250-262, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31752506

RESUMO

Objective: The present work aimed to evaluate: (a) the psychometric properties of the Centrality of Event Scale in Italian primiparous and multiparous women; (b) individual differences in those demographic variables that influence change in women's identity and the maternal role acquisition during pregnancy; (c) the association between the extent to which pregnancy has an impact on woman's life story and identity and prenatal attachment; (c) how the centrality of the pregnancy event is related to the experience of PTSD during pregnancy.Background: Pregnancy is a crucial phase in women's life that involves many changes for a woman's role and identity.Methods 319 pregnant women were assessd during the third trimester of pregnancy.Results: Exploratory Factor Analyses confirmed a one-factor solution of the CES. Moreover, the perception of pregnancy as central in women's lives is significantly related to prenatal attachment. Finally, the perception of pregnancy as central in women's lives is positively correlated to PTSD symptoms.Conclusion: Our findings provide evidence on the validity of the scale with pregnant women samples, which may contribute for a better understanding of the impact of pregnancy on women's identity and life story, as well as the underlying psychological challenges related to pregnancy.


Assuntos
Família , Gestantes , Análise Fatorial , Feminino , Humanos , Gravidez , Terceiro Trimestre da Gravidez , Psicometria
9.
J Reprod Infant Psychol ; 39(4): 371-381, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32064903

RESUMO

Introduction: Miscarriage is a stressful life event with negative consequences that can last into the subsequent gestation, increasing women's risk for psychological symptoms. Less clear in literature is whether having a living child may buffer the psychological impact of miscarriage on subsequent pregnancies.Objective: explore levels of depression, anxiety and fear of delivery in women with and without a previous miscarriage, taking into consideration the presence of a living child.Method: 208 women (M = 34.68) were recruited during the third trimester of gestation. The sample was composed of 159 women without a previous miscarriage (72.3% primiparae and 27.7% multiparae) and 49 women with a history of miscarriage (53.1% primiparae and 46.9% multiparae). Participants filled out a battery of questionnaires aimed at assessing anxiety, depression, and fear of delivery.Results: Primiparae reported higher levels of fear of childbirth than multiparae. Moreover, women without a history of previous perinatal loss showed lower levels of depression and fear of childbirth than women with a previous perinatal loss.Conclusions: Data highlight the importance of developing specific support groups, for primiparae, due to their great emotional vulnerability, and for women with past miscarriage, to help them cope in adaptive ways with a new pregnancy.


Assuntos
Aborto Espontâneo , Ansiedade , Criança , Medo , Feminino , Humanos , Parto , Gravidez , Terceiro Trimestre da Gravidez
10.
Int J Psychol ; 56(1): 143-150, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32319679

RESUMO

The aim of this study was to examine the relationships between three types of maternal attachment bonds: anxious romantic, avoidant romantic and prenatal. The moderating role of perceived social support is also analysed. Ninety-one pregnant women in or near their thirtieth week of gestation (M = 29.59; SD = 4.57) were recruited, all of whom completed a series of questionnaires to assess the quality of their romantic and prenatal attachment bonds and their levels of perceived social support. The results reveal that both anxious and avoidant romantic attachments were significantly associated with low levels of maternal prenatal attachment. Moreover, the level of social support perceived during pregnancy moderated the relationship between anxious and prenatal attachments but had no effect on avoidant romantic and prenatal attachments. Our discussion of these findings considers the emotional and behavioural characteristics of various forms of insecure romantic attachments. Overall, the data highlight the relevance of the quality of intimate close relationships on maternity experiences and women's caregiving abilities.


Assuntos
Comportamento Materno/psicologia , Apego ao Objeto , Cuidado Pré-Natal/psicologia , Apoio Social , Adulto , Feminino , Humanos , Masculino , Gravidez , Inquéritos e Questionários , Adulto Jovem
11.
J Obstet Gynaecol ; 39(4): 492-497, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30773960

RESUMO

Maternal symptomatology during pregnancy represents a significant risk factor for women and children. The main focus of this paper is to jointly investigate the role of maternal depression and anxiety during pregnancy on the well-being of the newborn, through their influences on the clinical aspects of labour. A longitudinal study was conducted on 167 pregnant women (Mage=32.07, SD = 4.50) recruited in the third trimester of gestation. The data was collected at two different times: the socio-demographical data and prenatal anxiety and depression were assessed at T1 (31-32 week of gestation); the clinical data on childbirth (duration of labour, administration of oxytocin and epidural analgesia) and the Apgar index of the newborn were registered at T2 (the day of childbirth). A structural equation modeling was performed using the MPLUS statistical programme. The results showed that a maternal psychopathological symptomatology during pregnancy constitutes a significant risk factor for the well-being of the newborn. In particular, both prenatal anxiety and depression negatively affect the clinical aspects of the labour experience and, indirectly, the Apgar index. The limitations, strengths, and theoretical and clinical implications are discussed. Impact statement What is already known on this subject? Depression and anxiety during pregnancy can negatively affect the well-being of women, the experience of labour and delivery, and birth outcomes. All of these aspects are documented in literature, however, they are usually analysed independently. What do the results of this study add? This is the first study that analyses all of the above psychological and clinical variables together, testing a theoretical model where prenatal anxiety and depression influence the newborn's Apgar index, through the clinical aspects of labour. The outcomes highlight the role that depressive and anxiety symptoms during pregnancy and the labour experience play on the newborn's wellbeing. What are the implications of these findings for clinical practice and/or further research? Overall, our data confirms the importance of putting a new light on maternal psychological symptoms during pregnancy and birth experience, considering them as complex human processes in which psychological and physical aspects are highly interconnected, influencing maternal and newborn well-being. Our results highlight how important it is that, when approaching the delivery experience, healthcare professionals pay attention not only to the physical condition of pregnant women and newborns, but also to the psychological condition of women, given the impact this can have on delivery and, therefore, on the baby's wellbeing.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Trabalho de Parto/psicologia , Complicações na Gravidez/psicologia , Terceiro Trimestre da Gravidez/psicologia , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Resultado da Gravidez/psicologia
12.
J Reprod Infant Psychol ; 37(4): 444-452, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30880451

RESUMO

Background: Depression symptomatology in pregnant women is a condition that represents an important risk factor for the health of both women and children. Objectives: The aim of this study was to investigate the influence of women's depression symptomatology on the clinical aspects of their delivery, both directly and indirectly, through mothers' prenatal attachment to their unborn children. Moreover, we analysed whether these aspects affect the well-being of the newborn, assessed through the Apgar score. Methods: A longitudinal design was carried out on a total of 203 pregnant women. At weeks 31-32 of gestation, women filled out the Beck Depression Inventory and the Prenatal Attachment Inventory. The day of childbirth, hospital healthcare staff registered the clinical data of childbirth. Results: A woman's depressive symptomatology negatively affects prenatal attachment to her unborn child and positively affects the clinical aspects of the delivery, both directly and mediated by the quality of prenatal attachment. Moreover, the Apgar score was negatively influenced by the clinical aspects of the delivery and, indirectly, by the depressive symptomatology. Conclusion: Depressive symptomatology during pregnancy has negative outcomes, affecting the delivery experience of women, the first emotional bond with the child, and the well-being of the newborn.


Assuntos
Depressão/psicologia , Trabalho de Parto/psicologia , Apego ao Objeto , Complicações na Gravidez/psicologia , Terceiro Trimestre da Gravidez/psicologia , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Relações Mãe-Filho/psicologia , Gravidez , Resultado da Gravidez/psicologia , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto Jovem
13.
Subst Use Misuse ; 50(12): 1560-70, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26583770

RESUMO

BACKGROUND: Alcohol use and alcohol-related problems represent a significant health concern. Few empirical researches focused on understanding the interrelationships and links between the parental bond, drinking motives, and alcohol use during adolescence. OBJECTIVES: The present study examined the relationships between a supportive parental bond, drinking motives, and alcohol use, with a focus on the role of mediation. METHODS: The sample comprised 298 adolescents, aged from 16 to 20 years. The technique of structural equation modelling (SEM) was used to assess the direct and indirect effects of the parental bond on alcohol use among adolescents through motives for drinking. RESULTS: The relationship between the parental bond and frequency of alcohol use by adolescents was not mediated by any motives for drinking, neither for males nor females. Regarding the relationships between the parental bond and quantity of adolescent alcohol consumption, findings for females showed significant indirect effects of maternal bond on alcohol quantity, when coping, enhancement, and social drinking motives were entered as mediator variables. Rather, paternal bond did not predict drinking quantity, not even indirectly. On the contrary, results for males indicated that the parental bond was neither directly nor indirectly associated with adolescent alcohol use. CONCLUSIONS/IMPORTANCE: Mothers are the relational fulcrum of the family, while fathers seem to maintain a more peripheral position. Gender differences are discussed on the basis of the different cultural and parental socialisation processes that operate for male and female adolescents.


Assuntos
Relações Pai-Filho , Relações Mãe-Filho , Motivação , Comportamento Social , Consumo de Álcool por Menores/psicologia , Adaptação Psicológica , Adolescente , Feminino , Humanos , Masculino , Consumo de Álcool por Menores/estatística & dados numéricos , Adulto Jovem
14.
Psychol Health Med ; 19(3): 263-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23725340

RESUMO

BACKGROUND: Amyloidosis is a rare disease group. AL amyloidosis represents the most common type of systemic amyloidosis and cardiac involvement determines prognosis. Although some studies have revealed that amyloidosis patients present high levels of depression, few data are available about depression-contributing factors. No investigations have been conducted about the coping strategies that AL amyloidosis patients use to face the disease and there is little research on patients with cardiac symptoms that are strongly related to the prognosis. OBJECTIVES: to examine coping strategies (avoidance, social support seeking and problem-solving) as potential mediator in the relationship between cardiac symptom severity (independent variable) and depressive symptoms (dependent variable) in AL cardiologic patients. METHOD: Thirty-four AL patients with cardiac-related symptoms were administered the Coping Strategy Indicator and the Centre for Epidemiological Study-Depression Scale. Clinical variables such as months since cardiac symptom onset and cardiac symptom severity were collected. RESULTS: According to questionnaire normative values, all patients presented clinical depression. Moreover, out of the coping strategies, avoidance and social support seeking mediated the link between cardiac symptom severity and depressive symptoms. No mediational effect was found for problem-solving. DISCUSSION: As cardiac symptoms have low severity, AL patients can avoid the disease. However, as cardiac symptoms proceed and interfere with daily activities, they can no longer ignore their signs thus perceiving the severity of their medical condition. This status makes individuals prone to seek less social support and thus to prefer social isolation. Results suggest the need for early psychological support on coping strategies for AL cardiologic patients.


Assuntos
Adaptação Psicológica/fisiologia , Amiloidose/psicologia , Depressão/psicologia , Cardiopatias/psicologia , Idoso , Idoso de 80 Anos ou mais , Amiloidose/complicações , Feminino , Cardiopatias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
15.
Children (Basel) ; 11(4)2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38671652

RESUMO

Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.

16.
Eur J Investig Health Psychol Educ ; 14(6): 1614-1626, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38921073

RESUMO

The role of anxiety is unknown in relation to postpartum bonding, unlike the well-known detrimental effect that postpartum depression has on the relationship between a mother and child. This study investigates how anxiety affects mother-infant bonding after childbirth, comparing the Italian version of the Postpartum Specific Anxiety Scale (PSAS-IT) with generalized measures of anxiety. Examining 324 non-randomly-selected participants responding to various scales, including the Edinburgh postnatal depression scale (EPDS), generalized anxiety disorder (GAD), postpartum-specific anxiety scale (PSAS-IT), postpartum bonding questionnaire (PBQ), and baby care questionnaire (BCQ-2), initial results suggest a link between certain postpartum anxiety symptoms and attachment problems. Surprisingly, anxiety measured with the PSAS has no direct influence on attachment; however, it is a strong predictor of bonding, even when maternal age, general anxiety, and depression are taken into account, explaining 3% of the variance in scores (ß = 0.26, p < 0.001). This emphasizes the importance of early identification and intervention of postpartum anxiety in promoting bonding between mother and child.

17.
Psychiatry Res ; 325: 115224, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37148834

RESUMO

This study aims to explore the level of depressive symptoms during pregnancy and after childbirth comparing women hospitalized due to high-risk pregnancy (clinical group) and women with low-risk pregnancy (control group). Seventy pregnant women (26 clinical group and 44 control group) filled in the Edinburgh Postnatal Depression Scale both during pregnancy and three months after childbirth. Results showed that the clinical group reported significant higher levels of prenatal depression than the control group, while no differences were found on postnatal depression. Data highlighted that hospitalization could represents a significant stressor that can exacerbate depression in women with high-risk pregnancy.


Assuntos
Depressão , Complicações na Gravidez , Gestantes , Humanos , Feminino , Gravidez , Recém-Nascido , Depressão/diagnóstico , Depressão Pós-Parto , Diagnóstico Pré-Natal , Gravidez de Alto Risco/psicologia , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Período Pós-Parto , Gestantes/psicologia , Parto , Estudos Longitudinais , Adulto
18.
Front Psychiatry ; 14: 1208613, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37621969

RESUMO

Introduction: While often positive, the lifecourse transition to motherhood is susceptible to the risk for developing mood disorders. Postpartum anxiety has often been overshadowed by other perinatal-specific mental health disorders, such as postpartum depression, and therefore has not been at the forefront or center of as much empirical study. This has meant there is a lack of effective and reliable tools with which to measure it, despite growing evidence suggesting its detrimental impact on mothers, their babies, wider family and social contacts, and on healthcare systems. This current study aimed to translate and validate the Postpartum Specific Anxiety Scale [PSAS] into the Italian language, and to validate the tool for its use in detecting anxiety specific to motherhood. Methods: The study (N = 457) comprised 4 stages: English-Italian translation and back-translation to obtain the Italian version [PSAS-IT]; a preliminary pilot study to adapt the PSAS to the characteristics of the Italian population; measurement invariance; and internal reliability of subscales. Results: The PSAS-IT demonstrates similar psychometric properties as the original English-language PSAS, with acceptable acceptability, construct and convergent validity, and internal consistency. Confirmatory factor analysis for multiple groups (Italy and United Kingdom) showed that the factor structure of the PSAS was valid for both groups [χ2 (2436) = 4679.481, p < 0.001, TLI = 0.969, CFI =0.972, RMSEA = 0.045, SRMR =0.064]. Discussion: The resulting findings offer a reliable measure of postpartum anxiety in Italian language up to six months after birth.

19.
Am J Cardiol ; 192: 1-6, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36689900

RESUMO

The subjective perception of cardiac symptom severity is considered a main treatment target in the management of transthyretin-related cardiac amyloidosis (CA), as opposed to objective prognostic markers such as N-terminal pro b-type natriuretic peptide (NT-proBNP), which objectively reflects the severity of heart disease. Nevertheless, anxious and depressive symptoms in patients with CA might affect subjects perceptions of disease, creating a potential gap between objective and subjective parameters. We assess the impact of such bias in consecutive patients with CA. A total of 60 patients aged 62 to 88 years with CA were recruited. The level of anxiety and depression was measured by the Hospital Anxiety and Depression Scale and the subjective perception of symptoms severity by the Kansas City Cardiomyopathy Questionnaire (KCCQ). Finally, NT-proBNP plasma levels at rest and glomerular filtration rate were measured. Nearly 1/2 of the patients (48%) reported clinically relevant levels of psychologic symptoms. Higher levels of anxious and depressive symptoms were significantly linked to lower KCCQ scores. Furthermore, the relation between NT-proBNP and KCCQ was significant only when anxious and depressive symptoms were low (ß = -0.86, p = 0.002; ß = -0.86, p = 0.002, respectively) and medium (ß = -0.49, p = 0.004; ß = -0.45, p = 0.004, respectively) but was otherwise lost. Depression and anxiety in patients with transthyretin-related CA required assessment and management. In conclusion, patients with depression/anxiety have a clear disconnect between their personal assessment and objective measures of cardiac symptoms, with a major influence on the patients' wellbeing and on their subjective response to treatments in clinical trials.


Assuntos
Amiloidose , Insuficiência Cardíaca , Humanos , Depressão , Pré-Albumina , Insuficiência Cardíaca/terapia , Ansiedade , Percepção , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Biomarcadores
20.
J Hum Lact ; 39(3): 478-487, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37278301

RESUMO

BACKGROUND: Women with a cancer history report high distress during pregnancy and infant feeding. Despite the clear advantages of breastfeeding, little is known about factors influencing infant feeding behavior in women with cancer history. RESEARCH AIM: This three-time point longitudinal study aimed to explore the centrality of pregnancy and infant feeding experiences in 17 pregnant women with a cancer history (cases) compared to 17 pregnant women without cancer history (controls). METHODS: During pregnancy, participants filled out the Centrality of Events Scale and an ad hoc questionnaire about specific emotions, concerns, and expectations about infant feeding (T1), and their childbirth and infant feeding experiences during hospitalization (T2), and at 3-months postpartum (T3). RESULTS: Results at T1 demonstrated that participants with a history of cancer reported a higher perception of negative judgment and moral choice about breastfeeding than participants without a history of cancer. At T2 they reported a more positive childbirth experience than controls. From T2 to T3 participants with a history of cancer breastfed at a higher percentage than controls, and at T3 they reported higher levels of emotional and physical pleasure about the infant feeding experiences. CONCLUSIONS: Women with cancer history may experience a higher emotional and physical pleasure with infant feeding. Despite initial difficulties, a greater prevalence of breastfeeding was present for women with a history of cancer. Although this is a small sample, this research suggests that support and promotion of breastfeeding might be very effective after a serious medical diagnosis.


Assuntos
Aleitamento Materno , Neoplasias , Lactente , Feminino , Gravidez , Humanos , Aleitamento Materno/psicologia , Estudos Longitudinais , Lactação , Parto , Neoplasias/complicações , Mães/psicologia
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